title: [Simvastatin (MK-733), a new HMG-CoA reductase inhibitor, in the treatment of hypercholesterolemia in elderly patients with atherosclerosis].
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of simvastatin, a new and potent HMG-CoA reductase inhibitor, in the treatment of hypercholesterolemia in elderly patients.
  
  
  METHODS
  Twenty patients, 14 female and 6 male, aged 65 to 72 years (x = 69 +/- 3), with total cholesterol (TC) above 260 mg/dl and triglycerides below 350 mg/dl were studied. All patients presented clinical evidences of atherosclerotic disease and were followed up for 6 months. Monthly visits were required for clinical and laboratory evaluation. The initial dosage of simvastatin was 10 mg/day; dosage was titrated up to 10 mg/day or to a minimum of 5 mg/day in intervals of at least 4 weeks, in order to maintain LDL-cholesterol below 140 mg/dl. To evaluate the changes on plasma lipid levels, the mean value of determinations during the placebo baseline period was compared to the mean value of determinations during the active treatment period.
  
  
  RESULTS
  There were significant reductions of total cholesterol (-26.4%), triglycerides (-16.0%), LDL-cholesterol (-35.2%), VLDL-cholesterol (-15.4%), TC/HDL-C (-30.7%), and LDL/HDL-C (-39.5%). There was significant elevation of HDL-cholesterol (+5.2%), although this response was not uniform. The drug was well tolerated: only five patients reported transient clinical adverse experiences that subsided spontaneously. Two patients had elevation of CPK and one of TGP. The drug did not have to be discontinued in any case. Ophthalmological examinations performed before treatment compared to examinations at the end of the study showed no signficant alterations.
  
  
  CONCLUSIONS
  Simvastatin in elderly patients appeared to be a potent TC and LDL-C lowering drug and presented mild but significant effect on the elevation of HDL-C. There was good tolerability, with low incidence of adverse experiences. This fact is important when one considers drug therapy for hypercholesterolemia in this age group.
authors.affiliation: Instituto do Coração do Hospital das Clínicas, FMUSP.
authors.forename: S D
authors.initials: SD
authors.lastname: Giannini
authors.forename: J M
authors.initials: JM
authors.lastname: de Góes
authors.forename: B E
authors.initials: BE
authors.lastname: Dereviack
authors.forename: C
authors.initials: C
authors.lastname: Machado
authors.forename: N
authors.initials: N
authors.lastname: Forti
authors.forename: J
authors.initials: J
authors.lastname: Diament
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001161:Arteriosclerosis / Q000150:complications*; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D008148:Lovastatin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D019821:Simvastatin
chemical_list: D008078:Cholesterol, LDL; D008055:Lipids; D002784:Cholesterol; D008148:Lovastatin; D019821:Simvastatin; D006903:Hydroxymethylglutaryl CoA Reductases; D000410:Alanine Transaminase; D003402:Creatine Kinase
vernacular_title: Sinvastatina (MK-733), novo inibidor da HMG-CoA redutase no tratamento da hipercolesterolemia do idoso com doença aterosclerótica.